Free PSA. What does it mean ?

Hi ~ Ken W,

Thought I’d reply with the info below. When I went to post…. your question had changed a little.

Any and all info is important…. So I will send this on…I hope this helps.

In Friendship ~ Lee





Excerpt from:

“Dr. Peter Scardino's Prostate Book”

Peter T. Scardino, M.D.

Chairman of the Department of Urology ant Memorial Sloan-Kettering Cancer Center and Judith Kelman





PSA comes in several varieties. Complex PSA circulates with a companion protein. Free PSA is a sort of bachelor antigen that travels on its own. This unbound form of PSA comes from BPH, not prostate cancer.

The widely available test for free PSA (%fPSA) indicates what percentage of your total PSA comes from benign enlargement of the gland. From this, we can predict the likelihood that a man with an elevated PSA would be found to have prostate cancer if we performed a biopsy. The test is especially useful for men whose PSA falls between 4 and 10, a gray area where either BPH or prostate cancer might be responsible for the increase. Testing for free PSA improves our ability to predict whether cancer is the cause of an elevated PSA by 20 to 40 percent yet reduces by only about 5 percent the cancers we would otherwise fail to detect. The measure can also be useful in characterizing a cancer after it has been diagnosed.

Reading over 25 percent suggest that the elevated PSA is largely caused by BPH. Any cancer present is more likely to be small and confined to the gland. On the other hand, having a free PSA under 10 percent suggests that your total PSA is mostly elevated by a cancer, which is likely to be large and require active, aggressive treatment. 22 Levels between 10 and 25 percent are harder to evaluate in terms of your outlook for a permanent cure. But, in general, the lower the free PSA, the greater the cause for concern.



There is a table/graph on page 145

BPH (benign prostatic hyperplasia)

FootNote Chapter 8

22
Catalona W, Partin A, Slawin K, Brawer M, Flanigan R, Patel A, Richie J, deKernion J, Walsh P, Scardino P, Lange P, Subong E, Parson R, Gasior G, Loveland K, Southwick P (1998). "Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial.".
JAMA
279 (19): 1542-7.

Hey Ken...

My bad... 

I saw your thread Free PSA.  What does it mean?

And I immediately reached for my book and started typing.

Then when I went to post I saw your information and I thought ~ hmmm I don't remember reading this... hmmmm 

My mind was so focused on getting some info to you!! I'm glad it helped... thanks for your reply back.

Take care and know we are keeping you close in thoughts and prayers...

In Friendship ~ Lee & Buddy

 

Lee,

The 2.19 PSA I posted above is my newest that I was waiting for.

Seeing my NEW, "Proton Friendy", Urologist in a few days and see how " Friendly" he is and what he thinks of my numbers.

Ken